War In The Balkans: Famine stalks the fleeing hordes as relief agencies struggle to keep up

THERE ARE four horsemen of the Apocalypse. Behind war and death there inevitably follow famine and pestilence. To the horrors already witnessed coming out of Kosovo we must now add the threat of hunger and disease among the ad hoc refugee camps which are springing up in Macedonia, Montenegro and Albania. But warning also came yesterday of a timetable of starvation.

"Within seven to 10 days those people may be malnourished and starving. And it is impossible to reach them at this time," said Catherine Bertini the executive director of the United Nations food agency, the World Food Programme in London yesterday. Increased international assistance was urgently required for those on the border but there was no way to reach the bulk of the population trapped inside Kosovo, where it is feared the internal food distribution system has collapsed under the pressure of the conflict. "We are not looking at people who are in desperate physical shape when they come over the border," Ms Bertini said. But, she said, that was because many had received WFP food inside Kosovo in recent months. "However, certainly a human being cannot stand very many days without access to food."

There is no way of knowing what the scale of the problem inside the region now is. Aid agencies are possibly over-estimating the immediciacy of the dangers but, since all the staff from the WFP and other UN agencies were pulled out of Kosovo before the air strikes began, there will be no way of monitoring the rate of deterioration. Only the condition of the ensuing flows of refugees will give a time-lagged clue.

Since Nato launched air strikes against Yugoslav targets a week ago, at least 140,000 people have fled Kosovo and aid officials say another 20,000 are on their way. It is one of Europe's largest forced exoduses since the Second World War and yesterday in Washington the US Assistant Secretary of State, Julia Taft, pledged to support the international aid organisations who are moving to help the thousands of refugees cross the Kosovo border. "For those who are able to get out, they will be able to avail themselves of international protection," she said. "We are going to be ready with the international community to provide assistance."

Even so the food which the WFP has been for some time stockpiling in the border regions of Kosovo's neighbours - in preparation for a flow of refugees - is likely to prove inadequate. "The situation is far graver than we anticipated because there are more people crossing the border - sometimes as many as 4,000 people an hour," Ms Bertini said.

Other international agencies and governments have also stepped in and aircraft loaded with humanitarian aid began converging on the Balkans yesterday. Yesterday the WFP sent 40 tons of wheat flour and 10 tons of high protein biscuits from the Albanian capital, Tirana to the northern Albanian town of Kukes, where some 70,000 refugees have fled.

On Monday, it sent 9.6 tons of biscuits to the area. On Tuesday, the agency delivered 90 tons of food to the Macedonian capital, Skopje, enough to feed 12,000 people for two weeks. But this is only a fraction of what will be needed.

Relief workers will also have to cope with increasingly difficult logistical problems. Refugees are being relocated to small communities in Albania, and the roads leading to those villages are poor and can only be reached by small vehicles. The agency is appealing for more vehicles as well as increased donations of vegetable oil, beans and sugar.

But by far the greatest problem is with those Kosovars - the vast majority of the population - who still remain inside Yugoslavia. At least half a million of them are thought to be displaced within their own land. Tens of thousands have left their homes and are in hiding in the hills.

Until last week, WFP staff had been working desperately to try to reach them on horseback and motorcycles. But the last monthly rations were handed out on March 23 - to a group of 120,000 internally displaced people. How long those with earlier hand-outs can eke them out must be uncertain. In addition, many of the UN stores have been looted, according to reports filtering out to WFP staff on the borders.

There is no obvious way of getting food to these people. "It is impossible to air drop food because it is difficult to locate where people are and planes are required to fly very low when dropping food, which would make them into targets and that is too much of a risk," Ms Bertini said. In any case the scale of the problem is likely to be far greater than can be coped with by air-drops. And it is likely to be more long-lived.

"The food crisis threatens to be a long-term problem because no harvest is expected this year." Ms Bertini said. Famine is not imminent, she said. "Famine is a massive number of people dying and that is not the situation," she said. "But this is just the beginning of a potential catastrophe and we are gearing up to prepare for the worst."